Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery
Authors: Mark D. Neuman, Susan S. Ellenberg, Jeffrey L. Carson, Frederick E. Sieber
Journal: Annals of Internal Medicine (2023)

LettersJanuary 2023Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture SurgeryMark D. Neuman, MD, MSc, Susan S. Ellenberg, PhD, Jeffrey L. Carson, MD, Frederick E. Sieber, MDMark D. Neuman, MD, MScUniversity of Pennsylvania Perelman School of Medicine, Philadelphia, PennsylvaniaSearch for more papers by this author, Susan S. Ellenberg, PhDUniversity of Pennsylvania Perelman School of Medicine, Philadelphia, PennsylvaniaSearch for more papers by this author, Jeffrey L. Carson, MDRutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey Search for more papers by this author, Frederick E. Sieber, MDJohns Hopkins University School of Medicine, Baltimore, MarylandSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L22-0367 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE: Drs. Yarmush and Ramadan comment on the magnitude of the difference in pain measures we observed on postoperative day 1 in patients randomly assigned to spinal versus general anesthesia. As we state in our article, we agree that these results should be interpreted cautiously—regardless of the magnitude of difference observed—because CIs were calculated without adjustment for multiple comparisons. We did not determine a priori the level of difference in pain that participants in our study would judge to be meaningful in choosing between spinal and general anesthesia (1). We thus refrained from commenting on the clinical significance of ...References1. Jaeschke R, Singer J, Guyatt GH. Measurement of health status. Ascertaining the minimal clinically important difference. Control Clin Trials. 1989;10:407-15. [PMID: 2691207] doi:10.1016/0197-2456(89)90005-6 CrossrefMedlineGoogle Scholar2. Neuman MD, Kappelman MD, Israel E, et al. Real-world experiences with generating real-world evidence: case studies from PCORI's pragmatic clinical studies program. Contemp Clin Trials. 2020;98:106171. [PMID: 33038503] doi:10.1016/j.cct.2020.106171 CrossrefMedlineGoogle Scholar3. Neuman MD, Ellenberg SS, Sieber FE, et al; REGAIN Investigators. Regional versus General Anesthesia for Promoting Independence after Hip Fracture (REGAIN): protocol for a pragmatic, international multicentre trial. BMJ Open. 2016;6:e013473. [PMID: 27852723] doi:10.1136/bmjopen-2016-013473 CrossrefMedlineGoogle Scholar4. Neuman MD, Feng R, Carson JL, et al; REGAIN Investigators. Spinal anesthesia or general anesthesia for hip surgery in older adults. N Engl J Med. 2021;385:2025-35. [PMID: 34623788] doi:10.1056/NEJMoa2113514 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Mark D. Neuman, MD, MSc; Susan S. Ellenberg, PhD; Jeffrey L. Carson, MD; Frederick E. Sieber, MDAffiliations: University of Pennsylvania Perelman School of Medicine, Philadelphia, PennsylvaniaRutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey Johns Hopkins University School of Medicine, Baltimore, MarylandDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-0320. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery Mark D. Neuman , Rui Feng , Susan S. Ellenberg , Frederick Sieber , Daniel I. Sessler , Jay Magaziner , Nabil Elkassabany , Eric S. Schwenk , Derek Dillane , Edward R. Marcantonio , Diane Menio , Sabry Ayad , Manal Hassan , Trevor Stone , Steven Papp , Derek Donegan , Mitchell Marshall , J. Douglas Jaffe , Charles Luke , Balram Sharma , Syed Azim , Robert Hymes , Ki-Jinn Chin , Richard Sheppard , Barry Perlman , Joshua Sappenfield , Ellen Hauck , Mark A. Hoeft , Ann Tierney , Lakisha J. Gaskins , Annamarie D. Horan , Trina Brown , James Dattilo , and Jeffrey L. Carson , on behalf of the REGAIN (Regional versus General Anesthesia for Promoting Independence after Hip Fracture) Investigators* Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery Joel Yarmush , Mohamed Ehab Ramadan Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery Yu Toda , Hiroto Ishiki , Taku Machida , Naruaki Kawasaki , Eisuke Kobayashi Metrics January 2023Volume 176, Issue 1KeywordsAnalgesicsAnesthesiaAnesthesiologyGeneral anesthesiaHip fracturesHospital medicineSurgery ePublished: 17 January 2023 Issue Published: January 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...